States push to expand nurse practice authority

Editor's Note

Recent legislative efforts in Florida and Mississippi aim to expand the authority of advanced practice registered nurses (APRNs) with measures that would remove supervisory requirements and allow independent practice for certain nurse practitioners. The efforts underscore an ongoing, nationwide debate over the role of APRNs in addressing provider shortages and streamlining patient care.

As detailed in a February 18 report in The Capitolist, the proposed legislation in Florida—Senate Bill 718 and House Bill 649—would grant Certified Registered Nurse Anesthetists (CRNAs) full practice authority. Current state law requires CRNAs to operate under written supervisory agreements with physicians, often involving financial arrangements that can limit practice autonomy. The bills propose removing these restrictions, allowing CRNAs to independently determine and administer anesthesia without physician oversight.

Supporters argue this change would address provider shortages, particularly in rural areas, by enabling CRNAs to deliver care without bureaucratic delays, the outlet reports. They also point to studies indicating that CRNAs provide anesthesia care that is both safe and cost-effective. Physician groups, however, oppose the measure, contending that anesthesia administration requires physician oversight to ensure patient safety.

In Mississippi, pending legislation seeks to remove the requirement for collaborative agreements between nurse practitioners (NPs) and physicians, according to a February 17 report from WLBT. Under existing law, NPs must enter into formal agreements with physicians to provide patient care, which some argue limits their ability to practice fully. The proposed legislation would allow NPs to operate independently, improving access to care, especially in underserved communities.

As detailed in the article, advocates emphasize that NPs are trained to diagnose and treat patients, prescribe medications, and manage chronic conditions without physician supervision, and that eliminating collaborative agreements would help fill critical gaps in the state’s healthcare workforce. Opponents, including some physician organizations, warn that removing these requirements could lower the standard of care, arguing that physician collaboration ensures patient safety and comprehensive treatment.